With many recent surgical advances, more adults over 75 than ever are having joint replacements, transplants and other major operations. According to the Centers for Disease Control and Prevention, more than a third of all major U.S. surgeries are performed on people over 65. While surgeries can help seniors stay active and engaged longer, for those with dementia or frailty, it’s important to consider health, expectations, and goals to support the best possible quality of life.
By 2030, researchers anticipate there will be about 84 million American seniors, many of whom will need surgery. Each year after the age of 65 presents a greater risk for complications and hospital readmissions for surgery patients, according to Johns Hopkins Medical. Many older adults have chronic conditions including high blood pressure, diabetes, and arthritis. Some may also have depression or dementia or take multiple prescription medications that can cause side effects.
A recent study found that older adults who are either frail or have probable dementia are at greater risk for death following surgery. According to HealthDay News, researchers found that among Americans over 65 who had major surgery between 2011 and 2017, 13 percent died the following year. Among frail seniors with signs including low weight, slow movement or fatigue, the one-year death rate was 28 percent. Patients with probable dementia had a nearly 33 percent risk of death in the year following a major surgery.
This new research highlights the need for careful pre-surgery assessments and interventions such as physical therapy to improve fitness before surgery, the use of geriatric anesthesia considerations, and post-surgery care. Patients and their families should clearly understand the risks, benefits, and potential alternatives when surgery is recommended. In patients with probable dementia, it is also important to prevent and treat signs of delirium, a common post-surgery complication for older adults that can be serious for people with dementia. Including a geriatrician in the post-surgery care team can be valuable in helping to improve recovery outcomes for elderly patients.